Cardiovascular drugs (Beta blocker, Antiplatelet, Anticoag, Ace-i)

Question 1

What are examples of beta blockers?

Answer 1

1. Atenolol
2. Propranolol
3. Bisoprolol

Question 2

What are beta blockers used to treat?

Answer 2

1. Hypertension
2. Angina
3. Arrhythmias
4. Heart failure
5. Post MI

Question 3

How to beta blockers work?

Answer 3

block beta adenoreceptors

Question 4

What system does beta blockers act on?

Answer 4

antagonist of the sympathetic nervous system

Question 5

What does blocking beta1 receptors do?

Answer 5

• negatively inotropic and chronotropic
  1. Decreased contractility
  2. Decrease heart rate

Question 6

What does blocking beta2 receptor do?

Answer 6

induces periperhal vasoconstriction and bronchoconstricton

Question 7

What are key contraindications for beta blocker?

Answer 7

1. severe asthma or COPD

2. heart block

Question 8

What are side effects of beta blockers?

Answer 8

1. lethargy
2. ED
3. nightmares
4. headaches

Question 9

What are examples of ACE inhibitors?

Answer 9

1. Captopril
2. Cilazapril
3. Enalapril
4. Ramipril

Question 10

What are ACE inhibitors used to treat?

Answer 10

1. Hypertension
2. Heart Failure
3. Post MI

Question 11

How do ACE inhibitors work?

Answer 11

1. Inhibit ACE enzyme
2. Vasodilation
3. Decrease BP

Question 12

When is there concern using ACE inhibitors?

Answer 12

1. malignant hypertension

2. CCF

Question 13

How do you use ACE-i with CCF / malignant hypertension?

Answer 13

1. Reduce diuretic dose initially

2. long acting ACE-i

Question 14

What do you need to monitor with ACE-i?

Answer 14

creatinine (if rise >20% issue) and if renal function decrease check renal artery stenosis

Question 15

When should you not use ACE inihibtors?

Answer 15

1. AKI
2. Hyperkalameia
3. Avoid starting with dehydrated patient

Question 16

What are the side effects of ACE-i?

Answer 16

1. Dry cough

2. Urticaria

Question 17

What are the different types of anticoagulant?

Answer 17

1. Low molecular weight heparin (LMWH)

2. Unfractioned heparin (UFH)

Question 18

When are anticoagulants used therapeutically?

Answer 18

1. DVT

2. PE

Question 19

When are anticoagulants used prophylactically?

Answer 19

1. Prevention of DVT/PE (post op)

2. Prevention of stroke (e.g. chronic AF or prosthetic heart valves)

Question 20

What are examples of LMWH?

Answer 20

1. Dalteparin
2. Enoxaparin
3. Tinzaparin

Question 21

When is LMWH used?

Answer 21

prevention and initial treatment of venous thromboembolism

Question 22

How does LMWH work?

Answer 22

inactivates factor Xa

Question 23

What are the benefits of LMWH?

Answer 23

1. T1/2 longer than UFH
2. One or two daily doses
3. Lab monitoring not required
4. Predictable effect

Question 24

What are the negatives of LMWH?

Answer 24

accumulates in renal failure

Question 25

How is UFH given?

Answer 25

IV or SC

Question 26

How does UFH work?

Answer 26

1. binds to antithrombonin | 2. increasing ability to inhibit thrombin, factor Xa and IXa

Question 27

What are the benefits of UFH?

Answer 27

1. Rapid onset | 2. Short T1/2

Question 28

What are the side effects for both types of heparin?

Answer 28

1. Increased risk of bleeding (GI, op, cranial) 2. Heparin induced thrombocytopenia (HIT) 3. Osteoporosis 4. Beware of hyperkalaemia

Question 29

What are the contraindications for both heparins?

Answer 29

1. Bleeding disorders 2. Platelets <60x10^9 / L 3. Previous HIT, peptic ulcer disease, cerebral haemorrhage, severe hypertension and neurosurgery

Question 30

How does warfarin work?

Answer 30

inhibits reductase enzyme which is needed to regenerate vit K so vit K definciency

Question 31

What are the contraindications of warfarin?

Answer 31

1. peptic ulcer 2. bleeding disorder 3. severe hypertension 4. pregnancy

Question 32

What are the disadvantages of warfarin?

Answer 32

- Change based on INR | - Narrow therapeutic window

Question 33

What is warfarin mostly used for?

Answer 33

``` -LT anticoagulation for: 1. mechanical valves 2. AF 3. clots ```

Question 34

What are examples of DOACs?

Answer 34

1. Rivaroxaban 2. Apixaban 3. Dabigatran (direct thrombin inhibitor)

Question 35

How does rivaroxaban and apixaban work?

Answer 35

factor Xa inhibitor

Question 36

Why DOACs better than warfarin?

Answer 36

don't nee regular monitoring (INR)

Question 37

What are contraindication of DOAC?

Answer 37

1. severe renal/liver impairment 2. active bleeding 3. lesion at risk of bleeding 4. decrease clotting factors

Question 38

What are interactions of DOACs?

Answer 38

1. heparin | 2. clopidogrel

Question 39

What is type of anticoagulant is used for acute coronary syndrome?

Answer 39

1. Fondaparinux: factor Xa inihbitor 2. Bivalirudin: thrombin inihitor 3. treatment dose LMWH

Question 40

What are different types of antiplatelet drugs?

Answer 40

1. Aspirin 2. ADP receptor antagonist 3. Glycoprotein IIb/IIa antagonist

Question 41

What are the examples of ADP receptor antagonist?

Answer 41

1. Clopidogrel 2. Prasugrel 3. Ticagrelor

Question 42

What is low dose aspirin (75mg/24h) used for secondary prevention of?

Answer 42

1. post MI 2. post TIA/stroke 3. have angina 4. have PVD

Question 43

How does aspirin work?

Answer 43

1. Irreversibly acetylases COX 2. Preventing production of thromboxane A2 3. Inhibiting platelet aggregation

Question 44

How do ADP receptor antagonsits work?

Answer 44

1. Block platelet aggregation | 2. Less gastric irritation than aspirin

Question 45

When are ADP receptor antagonists used?

Answer 45

1. intolerant to aspirin 2. with aspirin after acute coronary stent insertion 3. acute coronary syndrome

Question 46

What is an example of glycoprotein IIb/IIa antagonsit?

Answer 46

Tirofiban

Question 47

When are glycoprotein IIb/IIa antagonists used?

Answer 47

unstable angina and MI